Food Allergy Testing and Diagnosis

If eating a food gives you headaches, skin rashes, hives, abdominal cramping or difficulty breathing, you may have a food allergy.

Food allergies occur when you have an abnormal sensitivity to a food which is normally harmless. Fortunately, life-threatening food allergies are very rare. However, even if your food allergies are not fatal, they can still make you miserable.

The most common foods that cause allergies include peanuts, fish, shellfish, milk, eggs, tree nuts and wheat. The best possible treatment for food allergy is to avoid the specific food. In some cases, a food allergy can be life-threatening and in these cases, all efforts must be made to keep that food away from the child’s diet and his/her activities. Children with severe food allergies should be given additional attention since the probability of accidental ingestion is higher. In these cases, the child’s school or other daycare providers should be informed of the specific allergy. For those with severe food allergies, the Food Allergy Network can be a great resource and often provide food recall alerts.

When it's not obvious to you what foods you are allergic to, allergy testing can help give you the answers. With this information, most patients with food allergies are able to modify their diet, have healthy tasty meals and live perfectly normal lives.

With the help of an allergist, you can develop a treatment plan which helps you stay out of trouble in the first place and also gives you specific instructions on what to do if you have a reaction to a particular food.

The process of undergoing a food challenge is usually preceded by skin testing, followed by an IgE (a blood test), to determine the antibody levels of the specific food. If the IgE level is low, you, together with one of our providers, can discuss the potential risks and benefits of undergoing a food challenge. If it is medically indicated to proceed with the challenge, the patient will then go through a series of steps (starting with small amounts of the food and increasing the amount of food as tolerated), while being closely monitored in the office by a trained clinical staff. If ingestion of the food was not associated with any adverse reactions, it can be clinically assumed that the food can be ingested safely. However, if ingestion of the food was associated with an adverse event, from a medically point of view, the food in question should be avoided.

Food Challenges

Our associate physician, Dr. Hana Tartibi, has a special interest in treating children with food allergies. A procedure called “Oral Food Challenge” is currently being offered at our clinic and those patients that have undergone this safe, closely monitored procedure have been able to answer many questions regarding their allergy. The goal of this procedure is to determine whether the patient needs to continue to avoid the food in question or if they have outgrown their allergy to a specific food(s). Knowing that you or your child has “outgrown” a particular food allergy can provide an improved quality of life, as well as give you the ability to loosen past dietary restrictions. In children, it may also relieve any social stigma, which may have resulted as a result of having a specific food allergy. Being made aware that you no longer have an allergy to a particular food can be a life-long relief and provide the pleasure of knowing that you or your child can live more freely and enjoy food you have missed over the years.

The process of undergoing a food challenge is usually preceded by skin testing, followed by an IgE (a blood test), to determine the antibody levels of the specific food. If the IgE level is low, you, together with one of our providers, can discuss the potential risks and benefits of undergoing a food challenge. If it is medically indicated to proceed with the challenge, the patient will then go through a series of steps (starting with small amounts of the food and increasing the amount of food as tolerated), while being closely monitored in the office by a trained clinical staff. If ingestion of the food was not associated with any adverse reactions, it can be clinically assumed that the food can be ingested safely. However, if ingestion of the food was associated with an adverse event, from a medically point of view, the food in question should be avoided.

What is an oral food challenge?

An oral food challenge is most commonly recommended when an allergy test result and/or medical history indicates that the patient may no longer be allergic to a certain food. An oral food challenge involves eating a serving of the specific food in slow, graded increments, while being carefully monitored by a clinician. The food challenge procedure, in combination with standardized allergy tests, can help to determine whether a food needs to be avoided.

During a food challenge, the patient is given a very small amount of the specific food being evaluated and if tolerated, increasing amounts of the food will be given over a period of several hours. The patient will be observed for any adverse reactions, which can range from itching to abdominal pain and even difficulty breathing. If any symptoms develop, then the challenge is immediately terminated and the patient is treated accordingly. If the patient successfully passes the challenge, then the food can be reintroduced into the diet. Over the years, many patients that have passed their specific food challenge(s) in our office have been very grateful about their ability to loosen previous dietary restrictions and to reintroduce foods back into their diet that they were told to avoid indefinitely in the past.

If you feel that you or someone you know would benefit from undergoing a direct oral food challenge, please contact our office and we will be happy to answer any additional questions you may have.

Food Allergy Action Plan

The incidence of food allergy is on the rise and more and more people, particularly children, are significantly impacted by these allergies. Parents are often overwhelmed and are sometimes confused about the proper steps they should take to deal with their allergic child. First and foremost, especially in children over 18 months of age, it is important to diagnose the allergy and see what impact, if any, this has on the child’s allergic history. If clinically indicated, the food should be avoided as much as possible. For those who have had food allergies themselves or have a child with food allergies, this is not always an easy task. Besides multiple ingredients are often found in many foods, there is also the possibility of “cross-contamination”, a growing concern in many of the places where food is processed. However, it is equally important to keep in mind the importance of maintaining a well, balanced diet to keep up with the physical demands of a growing child.

The most common foods that cause allergies include peanuts, fish, shellfish, milk, eggs, tree nuts and wheat. In some cases, a food allergy can be life-threatening and all efforts must be made to keep that specific food away from the child. Children with severe food allergies should be given special attention since the probability of accidental ingestion is greater than it is with adults. The child’s daycare provider and school should be informed of the allergy and what appropriate actions should be taken if an accidental ingestion has taken place. Below is what we call a “Food Allergy Action Plan” and many of our patients have found this tool to be quite useful.

When Dr. Engler attended the annual meeting of the American College of Allergy, Asthma and Immunology in November of 2010, the current guidelines on the management of food allergies were debated. At that meeting, it was reiterated that it is important to breast feed your child for at least 4-6 months and to begin supplemental feedings thereafter, without restriction to any specific foods commonly eaten. Of course, if the child develops any symptoms suggestive of a food allergy such as eczema, hives or any more serious reactions, such as breathing difficulties, then that food should be avoided and a proper allergy evaluation should be undertaken. Several major studies (including desensitization for peanut and another for egg allergy) are currently underway and should offer great promise in the very near future. While avoidance remains the recommended treatment at this timed, it appears that there will be very promising treatment options within the next few years.